Working Out While Expecting

Exercise plays such an important role in maintaining health. And when you’re maintaining a body for two, it’s no time to skimp on fitness. While previously, exercise during pregnancy was approached with caution and even suspected as a risk for miscarriage, now the word is that exercise is as valuable to a pregnant mom as the number of a good babysitter.

In fact, the American College of Obstetrics and Gynecology (ACOG) recently revised its guidelines, giving an enthusiastic nod of approval for moderate daily exercise during pregnancy. “Pregnancy should not be viewed as a state of confinement, ” says Dr. Raul Artal, professor and chair of the department of ob-gyn and women’s health at Saint Louis University School of Medicine. Artal, who also authored the new ACOG guidelines, explains that new studies and knowledge of safety during prenatal exercise led to the view that it is safe for women to maintain an active lifestyle during pregnancy.
Finding Motivation

In fact, the latest research shows that exercise is not only safe for most pregnant women, it can lead to a range of health benefits from easing back strain, to reducing the incidence of varicose veins, or even relieving the symptoms of morning sickness. Some studies have also suggested that exercise during pregnancy results in fewer cesarean sections, a quicker recovery postpartum, speedier return to pre-pregnancy weight, and perhaps most motivating of all, an easier and shorter labor and birth.

According to Tia Willows, Vice President of fitness services with Bally Total Fitness, preparing for labor is the most important reason to exercise. “Certainly you get the ‘feel-good’ aspects from exercise throughout your pregnancy but there are particular benefits for labor and delivery since the strength of the muscle groups aids in labor.” And, adds Willows, “If you are physically fit, you have greater body awareness. You pay more attention to your overall health.”

But the benefits of exercise go beyond the body. “Exercise gives individuals a sense of well-being,” says Artal. “Women cope with the labor and delivery much better psychologically and have a positive outlook.”

And experts say there is no better time to practice good health than pregnancy. “Pregnancy is a unique time for behavior modification,” says Artal. “Women are more inclined to engage in healthy lifestyle during pregnancy more than before.”
Ease Into Exercise

Exercise No-No’s
Vigorous exercise in a hot, humid environment
Exercises that force you to exhale against closed air passageways
Exercise in the supine position [lying on the back] after the first trimester. You run the risk of depressing the vena cava, which can reduce the amount of blood flow and oxygen to your baby. You may also be dizzy or light-headed on your back.
Prolonged periods of motionless standing
Exercising to the point of exhaustion or breathlessness. This is a sign that your baby and your body cannot get the oxygen supply it needs.
Exercise that may result in a loss of balance. Pay attention to your center of gravity as it changes after the fourth month.
Exercise involving the potential for even mild abdominal trauma
Bouncing exercises should be approached with caution
Be careful with weight lifting exercise. Avoid lifting weights above your head or those that could strain the lower back.
As when you are not pregnant, it’s always wise to ease into an exercise regimen, rather than “jump” into it. “If you find you are pregnant, that should be an incentive to get going but you should start slowly, do things in moderation,” says Willows. In other words, this is not a time for couch potatoes to start taking a spinning class three times a week. Nor is it the time to add intensity to your workout. “You can’t look for huge gains and goals while you’re pregnant. It’s more about maintaining your physical health if you’re just starting a program. The intention should be to monitor your health and improve fitness rather than trying for great gain,” adds Willows.

Experts urge that pregnant women be aware that exercise during pregnancy needs special attention. The reason is that, during pregnancy, you are in a very complex physiological state. Your body is going through many changes. And as different as you look on the outside, it’s nothing compared to what’s going on inside. To begin, your cardiovascular system is pumping up to 50% more blood through your body during pregnancy, which means a rise in your resting heart rate and a harder-working heart. The result is that you can’t workout as hard as you did before pregnancy. As for the respiratory system, the diaphragm is pushed further into the chest cavity by the baby’s presence in the uterus, making it more difficult for you to breathe deeply and get oxygen. In terms of the musculoskeletal system, the priority is certainly to prepare you for pregnancy. The
“challenge” is exercising effectively without hurting yourself. Awareness of the state of your joints and ligaments during exercise is important to avoid spraining or straining your muscles and joints.

On a nutritional note, your body uses carbohydrates more quickly during pregnancy. Combined with the normal toll exercise takes on your carbohydrate level, you could experience a blood sugar reaction during exercise. So it’s important that you adjust for this in the diet.

For these reasons, the single most important thing to do before starting any exercise program during pregnancy is to check with your doctor for advice. And, in particular, women with certain medical or obstetric conditions, including chronic hypertension or active thyroid, cardiac, vascular or pulmonary disease, should be evaluated carefully in order to determine whether an exercise program is appropriate.

ACOG recommends abstaining from an exercise program if any of the following absolute contraindications are present:
Pregnancy induced hypertension
Pre-term rupture of membranes, Pre-term labor during the prior or current pregnancy or both
Incompetent cervix/cerclage
Persistent second or third trimester bleeding
Intrauterine growth retardation
Multiple gestation
In addition women with certain other medical or obstetric conditions, including chronic hypertension or active thyroid, cardiac, vascular or pulmonary disease, should be evaluated carefully in order to determine whether an exercise program is appropriate.

Once you gain the doctor’s green light and you’re on your way, you’ll have to be vigilant about checking your heart rate during exercise. Generally, you should work out at an intensity of 40% of your maximum heart rate for beginning exercisers, 60% for intermediate and 70% for advanced. Failing to keep your heart rate at the appropriate intensity for your fitness level and ensuring you get enough fluids could potentially cause you to overheat, which could be harmful to the baby. According to ACOG, your temperature (taken under the arm) should be less than 101 degrees F after exercising. And avoid hot tubs or steam baths, which can cause fetal damage and miscarriage.

Keeping hydrated is another critical component of exercise during pregnancy. And you should also wear comfortable, “breathable” clothing and no skid shoes as well as a supportive bra.

As for what exercises to do, experts say your choice should be based on what activities you enjoy most as well as your fitness goals. You may want to focus on strength, back relief or overall cardiovascular health. Generally, most exercises including swimming, walking, step class, jogging, rowing or cycling are usually fine for mom and baby. But naturally, use commonsense when choosing your routine. Topping the ob-gyn’s “reject list” are contact sports and other activities that could lead to injury. Interestingly, Dr. Artal says the leading unsafe activity for pregnancy is scuba diving–so put aside
the scuba gear until after baby has made her debut.

Whatever your choice for keeping fit with baby in the belly, it’s critical to make sure you warm up and cool down. And stop immediately if you experience dizziness, faintness, headaches, bleeding, pain or shortness of breath. “Use your experience,” says Willows. “Be smart about what you’re doing. The baby is the most important thing.”

Going Beyond

After nine months of battling the bulge and a successful delivery, you’re work is done, right? Isn’t it time to let the body have its own R&R? Wrong. Just because you have a little one to look after, don’t think the exercise battle is over. Recent study findings show that women who retain the weight they gained during pregnancy for even a year after childbirth are more likely to remain overweight or obese for at least another year.

So keep the exercise routine going beyond labor. You can even involve baby as he or she grows. Just remember that many of the physiologic changes of pregnancy persist for 4-6 weeks postpartum. So exercise routines you did pre-pregnancy should be resumed gradually based on your own capabilities. As always, whether before conception, pregnancy or postpartum, respect the cardinal rule of exercise: listen to your body. Your body will love you for it.